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Phase 2 N=49 Treatment

Pentostatin, Cyclophosphamide, and Rituximab in Treating Patients With Previously Untreated Chronic Lymphocytic Leukemia

Leukemia · Lymphoma

Enrolled (actual)
49
Serious AEs
36.7%
Results posted
Feb 2017
Primary outcome: Primary: Overall Objective Response — 10; 5; 26; 4 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
rituximab (Biological); cyclophosphamide (Drug); pentostatin (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Memorial Sloan Kettering Cancer Center
Primary completion
Jan 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
Overall Objective Response
10; 5; 26; 4; 1

Summary

RATIONALE: Pentostatin may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Giving pentostatin together with cyclophosphamide and rituximab may kill more cancer cells. PURPOSE: This phase II trial is studying the side effects and how well giving pentostatin together with cyclophosphamide and rituximab works in treating patients with previously untreated chronic lymphocytic leukemia.

Eligibility Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of chronic lymphocytic leukemia (CLL), as evidenced by an absolute lymphocytosis in the blood of at least 5,000 lymphocytes per microliter OR bone marrow lymphocytosis ≥ 30% of all nucleated cells
  • Previously untreated disease
  • Meets 1 of the following risk criteria as defined by the three-stage Rai system
  • Intermediate-risk disease
  • Must meet the criteria for active disease as defined by the NCI Working Group guidelines including the following:
  • Weight loss
  • Fatigue
  • Fevers
  • Evidence of progressive marrow failure
  • Splenomegaly
  • Progressive lymphadenopathy
  • Progressive lymphocytosis with a rapid doubling time
  • High-risk disease
  • Malignant lymphocytes must demonstrate B-cells via immunophenotypic or immunohistochemical analysis
  • Patients with small lymphocytic lymphoma (CLL type) are eligible

PATIENT CHARACTERISTICS:

Inclusion criteria

  • Karnofsky performance status 60-100%
  • Total bilirubin ≤ 2.0 mg/dL (patients with Gilbert disease or autoimmune hemolytic anemia should have an evaluation for other causes of hyperbilirubinemia, but if none are found they may be enrolled regardless of serum bilirubin)
  • Total creatinine ≤ 2.0 mg/dL OR creatinine clearance > 50 mL/min
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • Patients with autoimmune hemolytic anemia or autoimmune thrombocytopenia are eligible for treatment on this protocol regardless of disease stage

Exclusion criteria

  • Significant active infections
  • Ongoing hepatitis B infection, specifically hepatitis B antigen or surface antigen positivity
  • Patients who are hepatitis B antibody positive are eligible for this protocol

PRIOR CONCURRENT THERAPY:

  • Concurrent prednisone allowed provided it is used as brief courses (≤ 7 days) for inflammatory conditions unrelated to CLL
  • No prior cytotoxic therapy or rituximab for this cancer
  • No concurrent radiotherapy or other chemotherapy
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00541034). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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